Trumpcare Parlor Tricks

How the GOP was able to create momentum for the American Health Care Act out of thin air.

Michigan Rep. Fred Upton at the U.S. Capitol in 2015 in Washington.

Chip Somodevilla/Getty Images

One would have expected Michigan Rep. Fred Upton, a senior member of the House GOP conference and respected former chairman of the Energy and Commerce Committee, to face either some berating or nasty looks from House Republican leaders or his fellow chairmen when he stepped onto the House floor on Tuesday.

He had just delivered what appeared to be a devastating blow to the American Health Care Act, coming out against it based on the amendment that had brought conservatives on board at moderates’ expense. The move felt similar, in terms of its impact on the bill’s prospects for passage, as Appropriations Committee Chairman Rodney Frelinghuysen’s rejection of the AHCA in March that dealt a death blow to the first version. But when he got to the floor for an afternoon vote, Upton was met with a big smile and handshake from his successor as chairman of Energy and Commerce Committee, Rep. Greg Walden, a key player in the health care reform effort. What was going on?

Maybe it was just longtime colleagues with mutual respect greeting each other. Or maybe Walden knew that Upton would fold in his opposition soon enough, perhaps after securing a substantively cosmetic but politically potent concession for moderates, and in doing so would create political momentum out of thin air. Because that’s precisely what happened on Wednesday. And maybe Upton knew it would happen, too.

The policy tweaks that reverted Upton to the yes column overnight don’t square up with the policy objections he had previously listed. On Tuesday, Upton said that he had informed leadership he “cannot support this bill with this provision.” That was in reference to the MacArthur amendment, which weakened protections for those with pre-existing conditions, the price for bringing on reluctant conservative Freedom Caucus members. When asked later in the day whether increased funding for high-risk pools to help those hurt by the MacArthur amendment could persuade him to support the bill, Upton said that “more money does not do the trick.”

But more money did do the trick. By Wednesday morning Upton was supporting a bill that still very much contained the MacArthur amendment he had so staunchly opposed. The change—which would offer $8 billion over five years for high-risk pools in states that waive certain Obamacare regulations, a drop in the bucket compared to needed funding levels—was made at Upton’s behest. The amendment also brought Missouri Rep. Billy Long, another high-profile defector from earlier in the week, back to the yes column.

“I think it’s now likely to pass the House,” Upton said following his White House meeting.

It unclear how many yes votes the Upton amendment has delivered beyond Long. It certainly did create a profound sense of optimism on Capitol Hill on Wednesday afternoon that had been absent all week. Rumors floated throughout the day that a vote would come Thursday or Friday or—if everything aligned—Wednesday night. Following Wednesday’s final vote series, Majority Leader Kevin McCarthy instructed members to keep their schedules open for additional votes on Thursday.

Leaders have been able to spin Upton’s amendment as a big win for moderates, creating the sense of a moving train headed, finally, to a vote. It was a much bigger gift to leaders than leaders’ gift to moderates, a relatively small boost in funding to protect sick people from the damage that the main architecture of the bill still does them. This bill was stuck on Tuesday, not solely because of Upton, and now it’s moving toward a vote, thanks to Upton. Neat trick.